Provider Demographics
NPI:1033983267
Name:ALHAKIM, KAISAR ALI (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAISAR
Middle Name:ALI
Last Name:ALHAKIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 PISSARRO DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-6062
Mailing Address - Country:US
Mailing Address - Phone:650-921-2497
Mailing Address - Fax:
Practice Address - Street 1:4318 PISSARRO DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-6062
Practice Address - Country:US
Practice Address - Phone:650-921-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist